Background Infantile hemangioma (IH) is the most common benign
tumor of infancy. For children with IH who require treatment,
propranolol and other beta blockers have been shown to be safe and
effective. Although consensus guidelines for propranolol have been
published, anecdotal experience suggests that there remain variations in
management. This study was performed to document these variations
amongst providers and to identify areas for future research.
Methods We conducted an internet-based survey of clinicians who
treat patients with IH. Characteristics of respondents were collected.
Hypothetical cases and management scenarios were presented and
respondents were ask to comment on dosing, monitoring, frequency of
follow-up, duration of therapy, whether to taper or abruptly discontinue
mediation, and which patients should get additional evaluation.
Results Twenty-nine respondents participated in the survey:
pediatric hematologists/oncologists (n= 15), pediatric cardiologists (n=
10), dermatologists (n = 2), an ophthalmologist (n = 1), and a
neonatologist (n = 1). Most respondents use generic propranolol in
infants with growing IH of the head and neck, with a goal dose of 2
mg/kg/day, until approximately one year of age. A variety of management
strategies were documented including which patients should be treated,
optimal dose and duration of therapy, how patients should be monitored,
which patients should get additional work up, how propranolol should
best be discontinued, and how often to see patients in follow-up.
Conclusions This study demonstrates wide practice variations in
managing patients with infantile hemangioma. Further research is
indicated to address these variations and develop additional/updated